title: Chinese medicinal herbs for cholelithiasis.
abstract: BACKGROUND
  Cholelithiasis is a common disease of the biliary tract. Chinese medicinal herbs are being used widely as an alternative treatment in people with cholelithiasis, but their beneficial or harmful effects have not been assessed systematically.
  
  
  OBJECTIVE
  To assess the beneficial and harmful effects of Chinese medicinal herbs in people with cholelithiasis.
  
  
  METHODS
  We conducted searches in the Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, Science Citation Index Expanded, Chinese Medicine Conference Disc, and Chinese Bio-Medicine Disc to January 2013. We handsearched four Chinese journals. No language or year of publication restrictions were applied.
  
  
  METHODS
  Randomised clinical trials studying Chinese medicinal herbs for treatment of cholelithiasis.
  
  
  METHODS
  Two review authors (SJ, TG) independently extracted data. For dichotomous data, we estimated the risk ratio (RR), and for continuous data, we calculated the mean difference. We also calculated 95% confidence intervals (CI).
  
  
  RESULTS
  Eleven randomised trials with 1205 participants with asymptomatic or mild-to-moderate cholelithiasis were included. None of the randomised clinical trials compared a single Chinese medicinal herb with a Western medicine or with surgery. No placebo-controlled trials were identified. In the trials comparing one Chinese herbal medicine (Gandanxiaoshi tablet) versus another (Aihuodantong tablet), there was no significant difference in the improvement of upper abdominal pain after the end of treatment (RR 1.21; 95% CI 0.71 to 2.05), and the heterogeneity among trials was not substantial. No other outcomes could be assessed. The remaining trials of Chinese medicinal herbs (Qingdan capsule, Danshu capsule, Paishi capsule, Rongdanpaishi capsule), did not offer specific data on symptoms, signs, or change in gallstones that would permit assessment of significant differences in curative effects between the treatment and control groups. No serious adverse events were reported.
  
  
  CONCLUSIONS
  This review reveals no strong evidence that the analysed Chinese medicinal herbs have any beneficial effects on asymptomatic or mild-to-moderate cholelithiasis. Definitive conclusions will require much better designed randomised trials to reduce risk of bias and allow detailed assessment of clinical outcomes.
authors.affiliation: Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China. gantao123@yahoo.com.cn.
authors.forename: Tao
authors.initials: T
authors.lastname: Gan
authors.forename: Jun
authors.initials: J
authors.lastname: Chen
authors.forename: Shuli J
authors.initials: SJ
authors.lastname: Jin
authors.forename: Yiping
authors.initials: Y
authors.lastname: Wang
mesh_terms: D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D002769:Cholelithiasis / Q000188:drug therapy*; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D006801:Humans; D008517:Phytotherapy; D016032:Randomized Controlled Trials as Topic
chemical_list: D000924:Anticholesteremic Agents; D004365:Drugs, Chinese Herbal